ELIAS DAVID NETO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
6 resultados
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Agora exibindo 1 - 6 de 6
- Banff 2013 Meeting Report: Inclusion of C4d-Negative Antibody-Mediated Rejection and Antibody-Associated Arterial Lesions(2014) HAAS, M.; SIS, B.; RACUSEN, L. C.; SOLEZ, K.; GLOTZ, D.; COLVIN, R. B.; CASTRO, M. C. R.; DAVID, D. S. R.; DAVID-NETO, E.; BAGNASCO, S. M.; CENDALES, L. C.; CORNELL, L. D.; DEMETRIS, A. J.; DRACHENBERG, C. B.; FARVER, C. F.; III, A. B. Farris; GIBSON, I. W.; KRAUS, E.; LIAPIS, H.; LOUPY, A.; NICKELEIT, V.; RANDHAWA, P.; RODRIGUEZ, E. R.; RUSH, D.; SMITH, R. N.; TAN, C. D.; WALLACE, W. D.; MENGEL, M.The 12th Banff Conference on Allograft Pathology was held in Comandatuba, Brazil, from August 19-23, 2013, and was preceded by a 2-day Latin American Symposium on Transplant Immunobiology and Immunopathology. The meeting was highlighted by the presentation of the findings of several working groups formed at the 2009 and 2011 Banff meetings to: (1) establish consensus criteria for diagnosing antibody-mediated rejection (ABMR) in the presence and absence of detectable C4d deposition; (2) develop consensus definitions and thresholds for glomerulitis (g score) and chronic glomerulopathy (cg score), associated with improved inter-observer agreement and correlation with clinical, molecular and serological data; (3) determine whether isolated lesions of intimal arteritis (isolated v) represent acute rejection similar to intimal arteritis in the presence of tubulointerstitial inflammation; (4) compare different methodologies for evaluating interstitial fibrosis and for performing/evaluating implantation biopsies of renal allografts with regard to reproducibility and prediction of subsequent graft function; and (5) define clinically and prognostically significant morphologic criteria for subclassifying polyoma virus nephropathy. The key outcome of the 2013 conference is defining criteria for diagnosis of C4d-negative ABMR and respective modification of the Banff classification. In addition, three new Banff Working Groups were initiated.
- Recurrence of IgA Nephropathy after Kidney Transplantation in Adults(2021) UFFING, Audrey; PEREZ-SAEZ, Maria Jose; JOUVE, Thomas; BUGNAZET, Mathilde; MALVEZZI, Paolo; MUHSIN, Saif A.; LAFARGUE, Marie-Camille; REINDL-SCHWAIGHOFER, Roman; MORLOCK, Alina; OBERBAUER, Rainer; BUXEDA, Anna; BURBALLA, Carla; PASCUAL, Julio; MOOS, Seraina von; SEEGER, Harald; MANNA, Gaetano La; COMAI, Giorgia; BINI, Claudia; RUSSO, Luis Sanchez; FAROUK, Samira; NISSAISORAKARN, Pitchaphon; PATEL, Het; AGRAWAL, Nikhil; MASTROIANNI-KIRSZTAJN, Gianna; MANSUR, Juliana; TEDESCO-SILVA, Helio; VENTURA, Carlucci Gualberto; AGENA, Fabiana; DAVID-NETO, Elias; AKALIN, Enver; ALANI, Omar; MAZZALI, Marilda; MANFRO, Roberto Ceratti; BAUER, Andrea Carla; WANG, Aileen X.; CHENG, Xingxing S.; SCHOLD, Jesse D.; BERGER, Stefan P.; CRAVEDI, Paolo; RIELLA, Leonardo V.Background and objectives In patients with kidney failure due to IgA nephropathy, IgA deposits can recur in a subsequent kidney transplant. The incidence, effect, and risk factors of IgA nephropathy recurrence is unclear, because most studies have been single center and sample sizes are relatively small. Design, setting, participants, & measurements We performed a multicenter, international, retrospective study to determine the incidence, risk factors, and treatment response of recurrent IgA nephropathy after kidney transplantation. Data were collected from all consecutive patients with biopsy-proven IgA nephropathy transplanted between 2005 and 2015, across 16 ""The Post-Transplant Glomerular Disease"" study centers in Europe, North America, and South America. Results Out of 504 transplant recipients with IgA nephropathy, recurrent IgA deposits were identified by kidney biopsy in 82 patients; cumulative incidence of recurrence was 23% at 15 years (95% confidence interval, 14 to 34). Multivariable Cox regression revealed a higher risk for recurrence of IgA deposits in patients with a pre-emptive kidney transplant (hazard ratio, 3.45; 95% confidence interval, 1.31 to 9.17) and in patients with preformed donor-specific antibodies (hazardratio, 2.59; 95% confidence interval, 1.09 to 6.19). After kidney transplantation, development of de novo donor-specific antibodies was associated with subsequent higher risk of recurrence of IgA nephropathy (hazard ratio, 6.65; 95% confidence interval, 3.33 to 13.27). Immunosuppressive regimen was not associated with recurrent IgA nephropathy in multivariable analysis, including steroid use. Graft loss was higher in patients with recurrence of IgA nephropathy compared with patients without (hazard ratio, 3.69; 95% confidence interval, 2.04 to 6.66), resulting in 32% (95% confidence interval, 50 to 82) graft loss at 8 years after diagnosis of recurrence. Conclusions In our international cohort, cumulative risk of IgA nephropathy recurrence increased after transplant and was associated with a 3.7-fold greater risk of graft loss.
- Non-Human Leukocyte Antigen Antibodies Reactive with Endothelial Cells Could Be Involved in Early Loss of Renal Allografts(2011) RONDA, C.; BORBA, S. C. P.; FERREIRA, S. C. P.; GLOTZ, D.; IANHEZ, L. E.; RODRIGUES, H.; VIGGIANI, C. S.; NAHAS, W.; DAVID-NETO, E.; CASTRO, M. C. R.; DAISA, S. R. David; KALIL, J.; PANAJOTOPOULOS, N.Preformed donor-specific human leukocyte antigen (HLA) antibodies have been associated with allograft dysfunction and failure. However, recipients of HLA-identical kidneys can develop acute humoral rejection, implicating putative pathogenic antibodies that are directed against non-HLA antigens. We investigated the presence of endothelial cell reactive antibodies in 11 patients who experienced early loss of their transplanted kidneys owing to humoral rejection and 1 loss from renal venal thrombosis. We examined the potential efficacy of intravenous immunoglobulin to block the binding of these antibodies, as previously suggested for anti-HLA antibodies.
- Recurrence of FSGS after Kidney Transplantation in Adults(2020) UFFING, Audrey; PEREZ-SAEZ, Maria Jose; MAZZALI, Marilda; MANFRO, Roberto C.; BAUER, Andrea Carla; DRUMOND, Frederico de Sottomaior; O'SHAUGHNESSY, Michelle M.; CHENG, Xingxing S.; CHIN, Kuo-Kai; VENTURA, Carlucci G.; AGENA, Fabiana; DAVID-NETO, Elias; MANSUR, Juliana B.; KIRSZTAJN, Gianna Mastroianni; JR, Helio Tedesco-Silva; V, Gilberto M. Neto; ARIAS-CABRALES, Carlos; BUXEDA, Anna; BUGNAZET, Mathilde; JOUVE, Thomas; MALVEZZI, Paolo; AKALIN, Enver; ALANI, Omar; AGRAWAL, Nikhil; MANNA, Gaetano La; COMAI, Giorgia; BINI, Claudia; MUHSIN, Saif A.; RIELLA, Miguel Carlos; HOKAZONO, Silvia R.; FAROUK, Samira S.; HAVERLY, Meredith; MOTHI, Suraj Sarvode; BERGER, Stefan P.; CRAVEDI, Paolo; V, Leonardo RiellaBackground and objectivesFSGS recurrence after kidney transplantation is a major risk factor for graft loss. However, the natural history, clinical predictors, and response to treatment remain unclear because of small sample sizes and poor generalizability of single-center studies, and disease misclassification in registry-based studies. We therefore aimed to determine the incidence, predictors, and treatment response of recurrent FSGS in a large cohort of kidney transplant recipients.Design, setting, participants, & measurementsThe Post-Transplant Glomerular Disease (TANGO) project is an observational, multicenter, international cohort study that aims to investigate glomerular disease recurrence post-transplantation. Transplant recipients were screened for the diagnosis of idiopathic FSGS between 2005 and 2015 and details were recorded about the transplant, clinical outcomes, treatments, and other risk factors.ResultsAmong 11,742 kidney transplant recipients screened for FSGS, 176 had a diagnosis of idiopathic FSGS and were included. FSGS recurred in 57 patients (32%; 95% confidence interval [95% CI], 25% to 39%) and 39% of them lost their graft over a median of 5 (interquartile range, 3.0?8.1) years. Multivariable Cox regression revealed a higher risk for recurrence with older age at native kidney disease onset (hazard ratio [HR], 1.37 per decade; 95% CI, 1.09 to 1.56). Other predictors were white race (HR, 2.14; 95% CI, 1.08 to 4.22), body mass index at transplant (HR, 0.89 per kg/m(2); 95% CI, 0.83 to 0.95), and native kidney nephrectomies (HR, 2.76; 95% CI, 1.16 to 6.57). Plasmapheresis and rituximab were the most frequent treatments (81%). Partial or complete remission occurred in 57% of patients and was associated with better graft survival.ConclusionsIdiopathic FSGS recurs post-transplant in one third of cases and is associated with a five-fold higher risk of graft loss. Response to treatment is associated with significantly better outcomes but is achieved in only half of the cases.
- Predictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales: The impact of cytomegalovirus disease and lymphopenia(2020) PEREZ-NADALES, Elena; GUTIERREZ-GUTIERREZ, Belen; NATERA, Alejandra M.; ABDALA, Edson; MAGALHAES, Maira Reina; MULARONI, Alessandra; MONACO, Francesco; PIERROTTI, Ligia Camera; FREIRE, Maristela Pinheiro; IYER, Ranganathan N.; STEINKE, Seema Mehta; CALVI, Elisa Grazia; TUMBARELLO, Mario; FALCONE, Marco; FERNANDEZ-RUIZ, Mario; COSTA-MATEO, Jose Maria; RANA, Meenakshi M.; STRABELLI, Tania Mara Varejao; PAUL, Mical; FARINAS, Maria Carmen; CLEMENTE, Wanessa Trindade; ROILIDES, Emmanuel; MUNOZ, Patricia; DEWISPELAERE, Laurent; LOECHES, Belen; LOWMAN, Warren; TAN, Ban Hock; ESCUDERO-SANCHEZ, Rosa; BODRO, Marta; GROSSI, Paolo Antonio; SOLDANI, Fabio; GUNSEREN, Filiz; NESTOROVA, Nina; PASCUAL, Alvaro; MARTINEZ-MARTINEZ, Luis; AGUADO, Jose Maria; RODRIGUEZ-BANO, Jesus; TORRE-CISNEROS, Julian; SONG, A. T. Wan; ANDRAUS, W.; D'ALBUQUERQUE, L. A. Carneiro; DAVID-NETO, E.; PAULA, F. Jota de; ROSSI, F.; OSTRANDER, D.; AVERY, R.; RIZZI, M.; LOSITO, A. R.; RAFFAELLI, F.; GIACOMO, P. Del; TISEO, G.; LORA-TAMAYO, J.; SAN-JUAN, R.; GRACIA-AHUFINGER, I; CASTON, J.; RUIZ, Y. A.; ALTMAN, D. R.; V, S. Campos; BAR-SINAI, N.; KOPPEL, F.; ALMAJANO, F. Arnaiz de las Revillas; RICO, C. Gonzalez; MARTINEZ, M. Fernandez; MOURAO, P. H. O.; NEVES, F. A.; FERREIRA, J.; PYRPASOPOULOU, A.; IOSIFIDIS, E.; ROMIOPOULOS, I; V, M. Minero; SANCHEZ-CARRILLO, C.; LARDO, S.; COUSSEMENT, J.; DODEMONT, M.; JIAYUN, K.; MARTIN-DAVILA, P.; FORTUN, J.; ALMELA, M.; MORENO, A.; LINARES, L.; GASPERINA, D. D.; BALSAMO, M. L.; ROVELLI, C.; CONCIA, E.; CHIESI, S.; SALERNO, D. N.; OGUNC, D.; PILMIS, B.; SEMINARI, E. M.; CARRATALA, J.; DOMINGUEZ, A.; CORDERO, E.; LEPE, J. A.; MONTEJO, M.; LUCAS, E. Merino de; ERIKSSON, B. M.; DELDEN, C. van; MANUEL, O.; ARSLAN, H.; TUFAN, Z. Kocak; KAZAK, E.; DAVID, M.; LEASE, E.; CORNAGLIA, G.; AKOVA, M.Treatment of carbapenemase-producing Enterobacterales bloodstream infections in solid organ transplant recipients is challenging. The objective of this study was to develop a specific score to predict mortality in solid organ transplant recipients with carbapenemase-producing Enterobacterales bloodstream infections. A multinational, retrospective (2004-2016) cohort study (INCREMENT-SOT, ClinicalTrials.gov NCT02852902) was performed. The main outcome variable was 30-day all-cause mortality. The INCREMENT-SOT-CPE score was developed using logistic regression. The global cohort included 216 patients. The final logistic regression model included the following variables: INCREMENT-CPE mortality score >= 8 (8 points), no source control (3 points), inappropriate empirical therapy (2 points), cytomegalovirus disease (7 points), lymphopenia (4 points), and the interaction between INCREMENT-CPE score >= 8 and CMV disease (minus 7 points). This score showed an area under the receiver operating characteristic curve of 0.82 (95% confidence interval [CI] 0.76-0.88) and classified patients into 3 strata: 0-7 (low mortality), 8-11 (high mortality), and 12-17 (very-high mortality). We performed a stratified analysis of the effect of monotherapy vs combination therapy among 165 patients who received appropriate therapy. Monotherapy was associated with higher mortality only in the very-high (adjusted hazard ratio [HR] 2.82, 95% CI 1.13-7.06, P = .03) and high (HR 9.93, 95% CI 2.08-47.40, P = .004) mortality risk strata. A score-based algorithm is provided for therapy guidance.
- A large, international study on post-transplant glomerular diseases: the TANGO project(2018) UFFING, Audrey; PEREZ-SAEZ, Maria Jose; MANNA, Gaetano La; COMAI, Giorgia; FISCHMAN, Clara; FAROUK, Samira; MANFRO, Roberto Ceratti; BAUER, Andrea Carla; LICHTENFELS, Bruno; MANSUR, Juliana B.; TEDESCO-SILVA, Helio; KIRSZTAJN, Gianna M.; MANONELLES, Anna; BESTARD, Oriol; RIELLA, Miguel Carlos; HOKAZONO, Silvia Regina; ARIAS-CABRALES, Carlos; DAVID-NETO, Elias; VENTURA, Carlucci Gualberto; AKALIN, Enver; MOHAMMED, Omar; KHANKIN, Eliyahu V.; SAFA, Kassem; MALVEZZI, Paolo; O'SHAUGHNESSY, Michelle Marie; CHENG, Xingxing S.; CRAVEDI, Paolo; RIELLA, Leonardo V.Background: Long-term outcomes in kidney transplantation (KT) have not significantly improved during the past twenty years. Despite being a leading cause of graft failure, glomerular disease (GD) recurrence remains poorly understood, due to heterogeneity in disease pathogenesis and clinical presentation, reliance on histopathology to confirm disease recurrence, and the low incidence of individual GD subtypes. Large, international cohorts of patients with GD are urgently needed to better understand the disease pathophysiology, predictors of recurrence, and response to therapy. Methods: The Post-TrANsplant GlOmerular Disease (TANGO) study is an observational, multicenter cohort study initiated in January 2017 that aims to: 1) characterize the natural history of GD after KT, 2) create a biorepository of saliva, blood, urine, stools and kidney tissue samples, and 3) establish a network of patients and centers to support novel therapeutic trials. The study includes 15 centers in America and Europe. Enrollment is open to patients with biopsy-proven GD prior to transplantation, including IgA nephropathy, membranous nephropathy, focal and segmental glomerulosclerosis, atypical hemolytic uremic syndrome, dense-deposit disease, C3 glomerulopathy, complement- and IgG-positive membranoproliferative glomerulonephritis or membranoproliferative glomerulonephritis type I-III (old classification). During phase 1, patient data will be collected in an online database. The biorepository (phase 2) will involve collection of samples from patients for identification of predictors of recurrence, biomarkers of disease activity or response to therapy, and novel pathogenic mechanisms. Finally, through phase 3, we will use our multicenter network of patients and centers to launch interventional studies. Discussion: Most prior studies of post-transplant GD recurrence are single-center and retrospective, or rely upon registry data that frequently misclassify the cause of kidney disease. Systematically determining GD recurrence rates and predictors of clinical outcomes is essential to improving post-transplant outcomes. Furthermore, accurate molecular phenotyping and biomarker development will allow better understanding of individual GD pathogenesis, and potentially identify novel drug targets for GD in both native and transplanted kidneys. The TANGO study has the potential to tackle GD recurrence through a multicenter design and a comprehensive biorepository.